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Metformin + polyethylene glycol loxenatide is a fixed combination therapy used for the treatment of type 2 diabetes mellitus. Metformin is a well-established oral antihyperglycemic agent that primarily decreases hepatic glucose production and improves insulin sensitivity. Polyethylene glycol loxenatide (also known as PEG-loxenatide or PEX168) is a long-acting, once-weekly glucagon-like peptide 1 receptor agonist (GLP-1 RA). It lowers blood glucose by enhancing glucose-dependent insulin secretion, suppressing glucagon secretion, slowing gastric emptying, and reducing appetite. The combination has demonstrated superior glycemic control compared to metformin alone in multiple randomized controlled trials in patients with type 2 diabetes inadequately controlled on metformin monotherapy. The addition of PEG-loxenatide to metformin also results in weight loss and favorable effects on lipid profiles and blood pressure[1][2][3][4][5]. The safety profile is characterized mainly by mild gastrointestinal side effects; risk of hypoglycemia or weight gain does not increase significantly[1][2].
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